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07425 899611

Hay Fever Consultation (nasal spray)

Hay fever, also known as allergic rhinitis, is an allergic reaction that primarily affects the nose and eyes. It occurs when your immune system overreacts to allergens in the air, such as pollen, dust mites, pet dander, or mold spores. These allergens are typically harmless, but in people with hay fever, the immune system treats them as invaders and releases chemicals like histamine to defend against them.

1. About your Health

To help us understand that this treatment is the right option for you, please answer the following questions.

0%

Please state your gender

This refers to your biological gender

Male

Female

What is your date of birth?

Use the calendar to select your date of birth.

Please add your height (in cms)

Your height is important for the prescribers decision.

Please add your current weight (in kgs)

Please make sure to add your current weight. This may affect the prescriber's decision.

Do you have any recent or past medical history of note?

If so, please provide more information

Yes

No

Do you suffer from any allergies?

If so, please provide more information

Yes

No

Do you currently take any medication whatsoever?

Please list all your current prescription medication including any medication you buy over the counter.

Yes

No

Is there a history of medical disorder's within your family?

If so, please provide more information

Yes

No

Are there any other health/medical details you feel we should know?

If so, please provide more information

Yes

No

2. About your Condition

To help us understand that this treatment is the right option for you, please answer the following questions.

0%

Is this a repeat prescription?

Yes

No

Are you pregnant or breastfeeding?

Yes

No

Do you suffer predominantly with symptoms of runny nose, blocked nose, or sneezing?

Yes

No

Have you ever had an allergic reaction to Mometasone Furoate, Beconase (Beclometasone) or Benzalkonium Chloride?

Yes

No

Have you had nasal surgery in the last two months?

Yes

No

Have you been diagnosed with any of the following?

Glaucoma/ Raised intraocular pressure
Recurrent or untreated nasal infections
Unresolved complications following nasal surgery
Diabetes Mellitus

Yes

No

Are you currently taking any medication (including over the counter, prescription or recreational drugs)?

If so, please list the medications

Yes

No

Are you taking any of the following medications?

Warfarin, Rivaroxaban, Dabigatran, Apixaban (or any other anticoagulants)
Daily NSAIDS (e.g. Naproxen, Diclofenac or Ibuprofen)
Daily Aspirin
Anti-Epileptics
HIV retroviral treatments
Systemic steroid treatments
Immunosuppresive treatments
Previous hypersensitivity to steroid treatment (e.g. topical steroids for eczema)

Yes

No

Do you understand that to get the best results from a steroid nasal spray, you need to use it every day during your hayfever season?

Yes

No

Do you understand it can take a few days after starting a nasal steroid spray to see improvement, regular use is required to achieve full benefit and you should consult with you GP if your symptoms do not improve after 4 weeks of treatment?

Yes

No

Do you understand that you should not use nasal steroids for more than 3 months each year unless advised otherwise by your GP?

Yes

No

Do you understand that if you experience any localised side effects such as nasal pain or nose-bleeds you should stop your nasal steroid treatment and see your GP?

Yes

No

Is there anything else which you feel we should know about prior to you taking this medication?

Yes

No

3. The Agreement and Consent

Please answer the following questions to help us confirm that you'll follow the guidelines for this medicine.

0%

Do you agree to the following?

You will read the patient information leaflet supplied with your medication
You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment.
The treatment is solely for your own use
You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.

Yes

No

I agree to the Terms and Conditions and I confirm that I am over 18.
Terms and Conditions

Yes

No

About Us

Profarma Direct is a cutting-edge online pharmacy that specialises in lifestyle medicine and personalised prescriptions.

Marsh House Lane, Darwen, Lancashire, BB3 3JB, United Kingdom
07425 899611
For Sales & Orders:
info@profarmadirect.com
For General Enquiry:
info@profarmadirect.com

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How to check GPhC Registration

You can check our pharmacy details and registration status here. You can also see details of any Fitness to Practise decisions relating to a registrant.

GPhC Registration Number:

2076639

GPhC Registered Owner:

Profarma Direct Ltd

Superintendent Pharmacist:

Zakaria Jalgaonkar

GPhC Pharmacy Details:

Marsh House Lane, Darwen, Lancashire, BB3 3JB, United Kingdom

Copyright © 2024 Profarma Direct. All Rights Reserved.

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